摘要
目的比较口服右美托咪定和咪达唑仑在儿童眼科手术术前镇静中的应用效果。方法纳入80例拟行眼科手术的患儿,将患儿随机分为右美托咪定组和咪达唑仑组,各40例,术前给予口服相应的药物进行镇静。比较两组患儿的药物接受度,给药前及给药后60 min的镇静和焦虑评分、血流动力学指标,以及给药后60 min父母分离焦虑量表(PSAS)和面罩接受量表(MAS)评分。结果咪达唑仑组药物接受度得分高于右美托咪定组(P<0.05)。咪达唑仑组、右美托咪定组平均镇静起效时间分别为15 min、30 min,给药后60 min咪达唑仑组的镇静评分高于右美托咪定(P<0.05)。给药后60 min,咪达唑仑组的焦虑评分低于右美托咪定组,抗焦虑满意率高于右美托咪定组(P<0.05)。两组PSAS得分、MAS评分差异均无统计学意义(P>0.05)。给药后60 min,两组的心率及平均动脉压(MAP)均较前降低(均P<0.05),但咪达唑仑组的MAP值高于右美托咪定组(P<0.05),而两组的心率差异无统计学意义(P>0.05)。两组均未出现低血压、心动过缓、呼吸抑制、缺氧、呼吸暂停等不良反应,两组的胃肠道不良反应发生率差异无统计学意义(P>0.05)。结论口服右美托咪定和咪达唑仑用于眼科手术儿童术前镇静均具有较好的效果,且相对安全。但口服咪达唑仑的镇静作用起效更快,镇静和抗焦虑的效果更优,而右美托咪定作为一种新型口服药物,也有巨大的应用潜力。
Objective To compare the application effect of oral dexmedetomidine versus midazolam in preoperative sedation during pediatric ocular operation.Methods Eighty children scheduled for ocular operation were enrolled.The children were randomized to dexmedetomidine group(n=40)or midazolam group(n=40)and preoperatively underwent sedation therapy with oral administration of corresponding medicines.Multiple indicators were compared between the two groups,including drug acceptance,sedation/anxiety scores and hemodynamic indexes before medication and after 60 minutes of medication,as well as the Parental Separation Anxiety Scale(PSAS)score and the Mask Acceptance Scale(MAS)score after 60 minutes of medication.Results The score for drug acceptance in the midazolam group was higher than that in the dexmedetomidine group(P<0.05).The average onset time of sedation was 15 minutes in the midazolam group and 30 minutes in the dexmedetomidine group,and the midazolam group obtained a higher sedation score after 60 minutes of medication as compared with the dexmedetomidine group(P<0.05).After 60 minutes of medication,the midazolam group had a lower anxiety score and a higher satisfaction rate for anti-anxiety as compared with the dexmedetomidine group(P<0.05).There was no statistically significant difference in PSAS score or MAS score between the two groups(P>0.05).After 60 minutes of medication,heart rate and mean arterial pressure(MAP)were decreased in both groups as compared with the values before medication(all P<0.05),but the midazolam group yielded a higher MAP than the dexmedetomidine group(P<0.05),and no statistically significant difference was observed between the two groups in heart rate(P>0.05).No adverse reactions occurred in the two groups,such as hypotension,bradycardia,respiratory depression,hypoxia and apnea,and there was no statistically significant difference in incidence rate of gastrointestinal adverse reaction between the two groups(P>0.05).Conclusion Oral dexmedetomidine or midazolam can achieve a favorable eff
作者
陆敏
龙乾海
粟鸿林
骆喜宝
LU Min;LONG Qian-hai;SU Hong-lin;LUO Xi-bao(Department of Anesthesiology,the Second Affiliated Hospital of Guilin Medical University,Guilin 541199,China)
出处
《广西医学》
CAS
2021年第2期170-174,共5页
Guangxi Medical Journal
基金
广西壮族自治区中医药局自筹经费科研课题(GZZC2019139)
广西医疗卫生重点培育学科建设项目。
关键词
术前镇静
右美托咪定
咪达唑仑
口服给药
眼科手术
儿童
Preoperative sedation
Dexmedetomidine
Midazolam
Oral administration
Ocular operation
Children
